Case Study 2: St. Luke’s Health Care System

Week 8 Case Study 2 Submission

Case Study 2: St. Luke’s Health Care System

Due Week 8 and worth 140 points

Read the case study titled “St. Luke’s Health Care System” found at the end of Chapter 14 and linked here as a PDF.

Write a fully developed paper in which you:

1. Assess the probable difficulties of the IT executives at St. Luke’s view wireless networking as key lever in their quest to increase clinician productivity and improved patient care.
2. Analyze how the Mobility XE enables the IT department to centrally manage all wireless devices used by clinicians.
3. Critique the Mobility works solution and recommend one change to the solution to provide better productivity and improved patient care.
4. Use at least three quality resources in this assignment. Note: Wikipedia and similar websites do not qualify as quality resources.

Your assignment must follow these formatting requirements:

• Be typed, double-spaced, using Times New Roman font (size 12), with one-inch margins on all sides; references must follow APA or school-specific format. Check with your professor for any additional instructions.
• Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required page length.

The specific course learning outcomes associated with this assignment are:

• Analyze the technologies and architectures that have been developed for networking over shorter distances

  C9-1

  CASE STUDY 9

   

  ST. LUKE’S HEALTH CARE SYSTEM

  Hospitals have been some of the earliest adopters of wireless local area

  networks (WLANs). The clinician user population is typically mobile and

  spread out across a number of buildings, with a need to enter and access

  data in real time. St. Luke’s Episcopal Health System in Houston, Texas

  (www.stlukestexas.com) is a good example of a hospital that has made

  effective use wireless technologies to streamline clinical work processes.

  Their wireless network is distributed throughout several hospital buildings

  and is used in many different applications. The majority of the St. Luke’s

  staff uses wireless devices to access data in real-time, 24 hours a day.

  Examples include the following:

   

  • Diagnosing patients and charting their progress: Doctors and

  nurses use wireless laptops and tablet PCs to track and chart patient

  care data.

  • Prescriptions: Medications are dispensed from a cart that is wheeled

  from room to room. Clinician uses a wireless scanner to scan the

  patient’s ID bracelet. If a prescription order has been changed or

  cancelled, the clinician will know immediately because the mobile device

  displays current patient data.

   

  http://www.stlukestexas.com/

   

  C9-2

  • Critical care units: These areas use the WLAN because running hard

  wires would mean moving ceiling panels. The dust and microbes that

  such work stirs up would pose a threat to patients.

  • Case management: The case managers in the Utilization Management

  Department use the WLAN to document patient reviews, insurance

  calls/authorization information, and denial information. The wireless

  session enables real time access to information that ensures the correct

  level of care for a patient and/or timely discharge.

  • Blood management: Blood management is a complex process that

  involves monitoring both patients and blood products during all stages of

  a treatment process. To ensure that blood products and patients are

  matched correctly, St. Luke’s uses a wireless bar code scanning process

  that involves scanning both patient and blood product bar codes during

  the infusion process. This enables clinicians to confirm patient and blood

  product identification before proceeding with treatment.

  • Nutrition and diet: Dietary service representatives collect patient

  menus at each nursing unit and enter them as they go. This allows more

  menus to be submitted before the cutoff time, giving more patients

  more choice. The dietitian can also see current patient information, such

  as supplement or tube feeding data, and view what the patient actually

  received for a certain meal.

  • Mobile x-ray and neurologic units: St. Luke’s has implemented the

  wireless network infrastructure necessary to enable doctors and

  clinicians to use mobile x-ray and neurologic scanning units. This makes

  it possible to take x-rays or to perform neurological studies in patient

  rooms. This minimizes the need to schedule patients for neurology or

  radiology lab visits. The mobile units also enable equipment to be

  brought to the bedside of patients that cannot be easily moved. The

  wireless neurology and x-ray units have also helped to reduce the time

  between diagnosis and the beginning patient care.

   

   

  C9-3

   

  Original WLAN St. Luke’s first WLAN was deployed in January 1998 and made the hospital

  an early pioneer in wireless health care applications. St. Luke’s first wireless

  LAN was implemented in a single building using access points (APs) made by

  Proxim (www.proxim.com).

  A principal goal of this initial installation was to improve efficiency.

  However, sometimes the WLAN had the opposite effect. The main problem

  was dropped connections. As a user moved about the building, there was a

  tendency for the WLAN to drop the connection rather than performing the

  desired handoff to another access point. As a result, a user had to

  reestablish the connection, log into the application again, and reenter

  whatever data might have been lost.

  There were physical problems as well. The walls in part of the building

  were constructed around chicken wire, which interfered with radio waves.

  Some patients’ rooms were located in pockets with weak radio signals. For

  these rooms, a nurse or doctor would sometimes lose a connection and have

  to step out into the hallway to reconnect. Microwave ovens in the

  kitchenettes on each floor were also a source of interference.

  Finally, as more users were added to the system, the Proxim APs, with a

  capacity of 1.2 Mbps, became increasingly inadequate, causing ongoing

  performance issues.

   

  Enhanced LAN To overcome the problems with their original WLAN and reap the potential

  benefits listed earlier in this case study, St. Luke’s made two changes

  [CONR03, NETM03]. First, the hospital phased out the Proxim APs and

  replaced them with Cisco Aironet (www.cisco.com) APs. The Cisco APs, using

  IEEE 802.11b, operated at 11 Mbps. Also, the Cisco APs used direct

   

   

  C9-4

  sequence spread spectrum (DSSS), which is more reliable than the

  frequency-hopping technique used in the Proxim APs.

   

   

  The second measure taken by St Luke’s was to acquire a software

  solution from NetMotion Wireless (netmotionwireless.com) called Mobility.

  The basic layout of the Mobility solution is shown in Figure C9.1. Mobility

  software is installed in each wireless client device (typically a laptop,

  handheld, or tablet PC) and in two NetMotion servers whose task is to

  maintain connections. The two servers provide a backup capability in case

   

   

  C9-5

  one server fails. The Mobility software maintains the state of an application

  even if a wireless device moves out of range, experiences interference, or

  switches to standby mode. When a user comes back into range or switches

  into active mode, the user’s application resumes where it left off.

  In essence, Mobility works as follows: Upon connecting, each Mobility

  client is assigned a virtual IP address by the Mobility server on the wired

  network. The Mobility server manages network traffic on behalf of the client,

  intercepting packets destined for the client’s virtual address and forwarding

  them to the client’s current POP (point of presence) address. While the POP

  address may change when the device moves to a different subnet, from one

  coverage area to another, or even from one network to another, the virtual

  address remains constant while any connections are active. Thus, the

  Mobility server is a proxy device inserted between a client device and an

  application server.

   

  Enhancing WLAN Security In 2007, St. Luke’s upgraded to Mobility XE mobile VPN solution [NETM07].

  This migration was undertaken to enhance security and compliance with

  HIPPA data transmission and privacy requirements. Mobility XE server

  software was deployed in the IT department’s data center and client

  software was installed on laptops, handheld devices, and tablet PCs.

  With Mobility XE running on both clients and servers, all transmitted

  data passed between them is encrypted using AES (Advanced Encryption

  Standard) 128-bit encryption. Mobility XE also serves as an additional

  firewall; devices that are not recognized by the Mobility XE server are not

  allowed to access the network. This arrangement helped St. Luke’s achieve

  its IT goal of having encryption for all wireless data communications.

  Mobility XE also enables the IT department to centrally manage all

  wireless devices used by clinicians. This allows them to monitor the

   

   

  C9-6

  applications currently being used by any device or user, the amount of data

  being transmitted, and even the remaining battery life of the wireless device.

  If a Mobility XE device is stolen or lost, it can be immediately quarantined by

  network managers.

  IT executives at St. Luke’s view wireless networking as key lever in their

  quest to increase clinician productivity and improved patient care. Mobile

  EKG units have been deployed bringing the total of wireless devices in use to

  nearly a 1,000.

   

  Discussion Questions 1. Visit the NetMotion Web site (www.netmotionwireless.com) and access

  and read other Mobility XE success stories. Discuss the patterns that can be observed in the benefits that Mobility XE users have realized via its deployment and use.

  2. Do some Internet research on the security implications of HIPPA

  requirements for hospital networks. Discuss the major types of security mechanisms that must be in place to ensure hospital compliance with HIPPA requirements.

  3. Do some Internet research on the use of VLANs in hospitals.

  Summarize the benefits of using VLANs in hospitals and identify examples of how St. Luke’s could further enhance its wireless network by implementing VLANs.

   

  Sources [CONR03] Conery-Murray, A. “Hospital Cures Wireless LAN of Dropped Connections.” Network Magazine, January 2003. [NETM03] Netmotion Wireless, Inc. “NetMotion Mobility: Curing the Wireless LAN at St. Luke’s Episcopal Hospital. Case Study, 2003. Netmotionwireless.com/resources/case_studies.aspx. [NETM07] Netmotion Wireless, Inc. “St. Luke’s Episcopal Health System: A Case Study in Healthcare Productivity.” 2007. Retrieved online at: http://www.netmotionwireless.com/st-lukes-case-study.aspx

   

  http://www.netmotionwireless.com/

  http://www.netmotionwireless.com/st-lukes-case-study.aspx
  • CASE STUDY 9
    • Original WLAN
    • Enhanced LAN
    • Enhancing WLAN Security
    • Discussion Questions
    • Sources